Impact of the COVID-19 pandemic on emergent pacemaker implantation during lockdown and its aftermath

Abstract Background COVID-19 was first considered a pandemic on the 11th of March 2020 by World Health Organization. Its impact comprised not only direct consequences disease but decrease in follow-up and interventions patients with cardiovascular (CV) disease. In Portugal World, this complex paradigm shift emergent pacemaker implantation rates during after is largely unknown. Purpose We sought to analyse rate patient profile tertiary hospital Portuguese lockdown subsequent post-lockdown period. Methods retrospectively reviewed clinical who had pacemakers implanted our an urgent/emergent setting from 18, May 17, (lockdown) 19 July (post-lockdown). This data then directly compared homologous periods year before (H1 H2, respectively). Results A total 180 submitted were included. The cohort 29 lockdown, 60 post-lockdown, 38 H1 (+31% vs lockdown) 53 H2. Average age gender proportion similar for all groups. When comparing periods, number cases significantly increased second period (+106.9%) there tendency higher temporary use (3.4% 16.7%; p=0.076). Patients admitted 7.57 times more likely present hypotension/shock (odds ratio (OR) 7.57; p=0.013). Regarding its 2019 period, (−23.7%). Again, hypotension presentation (p=0.054). comparison saw slight increase (+13.2%) presented bradycardia (16.7% 3.8%; p=0.026). Also note, no emergency department anomalies detected ambulatory tests (Holter, electrocardiogram or loop recorder). Conclusion During generally severe, greater presenting hypotension/shock. addition, appears be effect bradyarrhtmias admissions profound impact: admission severe presentations including need pacemaker. symptoms suggestive bradyarrhythmias should advised promptly regardless pandemic. FUNDunding Acknowledgement Type funding sources: None. Pacemakers lockdown/post-lockdown diagnosis